Individual provider Active NPI

Jawaharlall Jeff Chajulall, APRN

  • Family Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1962140236
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11026839 Issued in FL
Practice address
9832 US Highway 441 Ste 101
Leesburg, FL 34788-3984
Phone
(352) 787-3341
Fax
(352) 787-7491
NPI assigned
May 25, 2022
Last updated
May 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11026839 FL Primary

Addresses

Primary practice location

9832 US Highway 441 Ste 101
Leesburg, FL 34788-3984

Mailing address

3150 Winifred Ave
Zellwood, FL 32798-0908
Phone (407) 446-4002

Other practice location 1

1400 N US Highway 441 Ste 540
Lady Lake, FL 32159-8987
Phone (352) 753-9777

Other identifiers 1

IdentifierTypeStateIssuer
120808200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220708000337 FL Practitioner - Nurse Practitioner 2567842552 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Vizavee Urgent and Primary Care, LLCGroup PAC ID 1557764784, 15 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

340 Heald Way
Suite 208
The Villages, FL 32163-6000
Phone (352) 399-7301

4669 E Sr
44 Suite 101
Wildwood, FL 34785-7460
Phone (352) 399-7301

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Multi-Specialty CurrentSince Jan 8, 2024 Accepting new patients
Vizavee Urgent & Primary Care, LLC Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Cardiothoracic & Vascular Surgical Associates PA Multi-Specialty Past Accepting new patients

Locations

9832 US Highway 441
Ste 101
Leesburg, FL 34788
Phone (352) 787-3341

4420 Sun N Lake Blvd
Fl Cancer
Sebring, FL 33872
Phone (863) 385-1244

1400 N US Highway 441
Ste 540
The Villages, FL 32159
Phone (352) 561-3290

340 Heald Way
Ste 208
The Villages, FL 32163
Phone (352) 259-5762

910 Old Camp Rd
Ste 114
The Villages, FL 32162
Phone (352) 259-4322

4669 E State Road 44
Ste 101
Wildwood, FL 34785
Phone (352) 399-7301

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24264/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jawaharlall.chajulall.1@24264.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1962140236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 WINIFRED AVE",
            "city": "ZELLWOOD",
            "state": "FL",
            "postal_code": "327980908",
            "telephone_number": "407-446-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9832 US HIGHWAY 441 STE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883984",
            "telephone_number": "352-787-3341",
            "fax_number": "352-787-7491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 N US Highway 441 Ste 540",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321598987",
            "country_code": "US",
            "telephone_number": "352-753-9777",
            "fax_number": "866-446-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAJULALL",
        "first_name": "JAWAHARLALL",
        "middle_name": "JEFF",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11026839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120808200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.